Abstract
Background: Management of the post-operative pain after cesarean section (CS) requires a balance between the pain relief and undesirable side effects of drugs. To improve the post-operative pain management after CS, we compared analgesic efficacy of i.v nalbuphine versus i.v paracetamol for post-operative CS pain.

Aim and Objective: The aim of the study was to compare the efficacy and safety of single-dose intravenous nalbuphine versus intravenous paracetamol for post-operative analgesia CS pain.

Materials and Methods: This was a hospital-based retrospective study in the department of obstetrics, gynecology, among 120 patients of CS. We enrolled 120 patients in our prospective randomized trial after an uneventful elective CS under the spinal anesthesia. Group A patients received i.v paracetamol infusion and Group B patients received i.v nalbuphine on the first complaint of pain. The results were analyzed byt-test; P<0.05 was taken as significant.

Results: The numeric rating score for pain and need for rescue analgesia were significantly lower in i.v nalbuphine group as compared to i.v paracetamol group. Changes in pulse rates were found statistically significant in patients receiving nalbuphine with the mean pulse rate within 74.90±3.93 BPM in comparison to patients receiving paracetamol with the mean pulse rate within 81.09±4.32 BPM (P<0.05). Changes in systolic blood pressure (SBP) were found statistically significant in patients receiving nalbuphine with mean SBP 118±2.68 mmHg in comparison to patients receiving paracetamol with mean SBP 114±2.82 mmHg (P<0.05). Changes in diastolic blood pressure (DBP) were found statistically significant in patients receiving nalbuphine with mean DBP 79.1±2.07 mmHg in comparison to patients receiving paracetamol with mean DBP 74±2.19 mmHg (P<0.05). None of the patients had hypotension in both groups. In our study, both paracetamol and nalbuphine are found to be having better hemodynamic stability. Further rescue analgesics used were significantly high in paracetamol group with maximum 8±1.08 rescue analgesic doses used and in nalbuphine group maximum 2±1.02 rescue analgesic doses were used.

Conclusion: Our results showed improved pain control, more hemodynamic stability, and less need for the rescue analgesia with i.v nalbuphine in post-operative period in patients of CS.

Key words: Post-operative pain; Nalbuphine, Paracetamol; Cesarean section